How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $281.84 Median $3,981.07 Typical High $7,413.10 | Facility | None | $281.84 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $302.00 | Professional | None | $257.04 | $281.84 | $302.00 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $630.96 | Professional | None | $275.42 | $309.03 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $269.15 Typical High $758.58 | Professional | None | $263.03 | $269.15 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $562.34 Typical High $630.96 | Professional | None | $245.47 | $562.34 | $630.96 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $776.25 | Professional | None | $229.09 | $407.38 | $776.25 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $138.04 Typical High $151.36 | Professional | 52 · Reduced service | $128.82 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $56.23 Typical High $60.26 | Professional | 53 · Discontinued | $51.29 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $208.93 Typical High $223.87 | Professional | 54 · Surgery only | $194.98 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $41.69 Typical High $45.71 | Professional | 55 · Aftercare only | $38.90 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.18 Typical High $30.20 | Professional | 56 · Pre-op care only | $25.70 | $28.18 | $30.20 |
Where Washington, DC sits
The same service costs 4.8 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Washington, DC· 38th of 51
$309
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.